•“The problem is, when we treat cancer cells with chemotherapy, the cancer stem cells are being stimulated to grow too.”

•“When we take mesenchymal stem cells and mix them with tumor cells, the tumors grow much more quickly in animals.”

In the News:

Cancer expert tells how treatment can be problem
Wednesday, February 24, 2010

By Mark Roth, Pittsburgh Post-Gazette

Max Wicha: Hopes cancer treatments can avoid general chemo altogether and just use targeted therapies against the stem cells.

Max Wicha is coming to Pittsburgh today to deliver a startling message. Standard cancer treatments not only often fail to eradicate cancer, but can make it worse.

That argument isn’t coming from a fringe proponent of alternative medicine, but from the founder of the University of Michigan’s Comprehensive Cancer Center and a pioneer in research on why cancers recur and spread to other parts of the body.

The reason breast cancer and other malignancies often return aggressively after treatment is that when tumor cells die under assault from chemotherapy and radiation, they give off substances that can reactivate a special set of master cells known as cancer stem cells, Dr. Wicha said in an interview Tuesday….

Dr. Wicha’s lab has found that inflammatory molecules secreted by dying tumor cells can hook up with the stem cells and cause them in effect to come out of hibernation.

•Adult stem cells exist in most tissues, and go into action to repair damage from wounds or infections.

•He and other researchers say that even when chemotherapy and radiation cause tumors to shrink dramatically, these stem cells can stay alive, living under the radar until they are once again spurred into action.

•They also believe stem cells are probably the ones that break away from an original tumor and cause cancer to spread elsewhere in the body.

•Chemo and radiation kill off the fastest-growing cells in the body, which applies to most cancer cells, but the cancer stem cells that create those rapidly dividing tumor cells actually grow much more slowly themselves, and are less susceptible to those therapies, he said.

•One tactic to address this problem is to kill off both types of cancer cells at once, Dr. Wicha said.

•A recent experimental trial with advanced breast cancer patients at the University of Michigan, Baylor University in Texas and the Dana-Farber Cancer Institute at Harvard University used standard chemotherapy along with a substance designed to block one of the biochemical pathways of stem cells.

•The approach killed off more than 90 percent of the cancer stem cells, Dr. Wicha said, and researchers now hope to expand the treatment to a much larger group of patients.

•Ultimately, he hopes cancer treatments can avoid general chemo altogether, with its debilitating side effects, and just use targeted therapies against the stem cells.

•There is still a long road ahead, he said, and “my feeling is, to really knock these stem cells out, we’re probably going to have to use multiple inhibitors.“

An article published by the Post-Gazette claimed that our research suggests cancer treatments “not only often fail to eradicate cancer, but can make it worse” This statement has been misinterpreted by patients currently receiving radiation or chemotherapy treatments. I have been contacted by both my own patients and Pittsburgh-area patients who have questioned whether they should continue with their chemotherapy. In fact, these treatments are lifesaving for many patients.

Our work does suggest that the resistance of a small population of tumor cells to these treatments may account for some of their limitations. Based on this, we are working to develop new approaches to target this specific cell population — treatments that could augment chemotherapy and radiation therapy. New treatments based on this theory are in their early testing stages. Only through the conduct of rigorous clinical trials will we be able to determine whether addition of these new therapies improves the outcome for patients with cancer.

In the meantime, patients diagnosed with cancer need to follow their doctors’ recommendations for treatment according to the current standards of care and inquire whether they are eligible for a clinical trial.

This web site is neither for advertising nor dispensing of medical advice. Clients who consult with Dr. Weeks receive information in an educational context in an effort to learn about optimizing care with their local health care practitioners. Dr. Weeks formerly practiced on Whidbey Island off the coast of Washington.